Clock Drawing Test

The Clock Drawing Test was first published in 1993 by Shulman et al. [1] and is used for early detection and monitoring of dementia. The test examines visuoconstruction, memory, spatial perception, executive functions, and problem solving. The modification according to Thalmann et al. from 2002 [2] – which is used here – is best suited for the screening of dementia.
Implementation

  1. Give the page with the clock drawing test and the given circle to the patient. (Link to template as PDF).
  2. Give the following instructions: «Please draw a clock with all the numbers and pointers needed and tell me when you are done.»
  3. «Please write the time of your drawn clock in the box below, as it would appear in a TV guide or timetable, for example.»
Are there 12 numbers?
Is the number «12» on top?
Are there two distinguishable pointers (e. g. thickness or length)?
Does the drawn time match the time in the «timetable format»?

Clock Drawing Test:

Interpretation
Points Assessment Recommendation
7 Test normal
6 Test abnormal Extend dementia screening, e. g. by using the «Montreal Cognitive Assessment» (MoCA) or «Mini-Mental State Exam» (MMSE)
≤ 5 Test pathological Further investigation of dementia recommended.
References
  1. Shulman KI, Pushkar Gold D, Cohen CA et al. Clock-drawing and dementia in the community: A longitudinal study. International Journal of Geriatric Psychiatry 1993; 8: 487-496
  2. Thalmann B, Spiegel R, Stähelin HB et al. Dementia screening in general practice: optimised scoring for the clock drawing test. Brain aging 2002; 2: 36-43

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